Sequential liver–kidney transplantation in a boy with congenital hepatic fibrosis and nephronophthisis from a living donor

Udagawa, Tomohiro; Kamei, Koichi; Ogura, Masao; Tsutsumi, Akiko; Noda, Shunsuke; Kasahara, Mureo; Fukuda, Akira; Sakamoto, Seisuke; S, Shigeta; Tanaka, Hideaki; Kuroda, Tatsuo; Matsuoka, Kentarou; Nakazawa, Atuko; Nagai, Takuto; Uemura, Osamu; Ito, Shuichi

doi:10.1111/j.1399-3046.2011.01611.x

Cited by 11 publications

(10 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Today, more than a quarter of a century has passed since the first report in 1985 of a double‐organ transplantation consisting of the liver and kidney from a deceased donor for a patient with primary hyperoxaluria type 1 (PH1). Although sequential double organ transplantation from a living donor is not used worldwide as a treatment option because of the need for organ donation from a healthy individual, several patient reports had been published to date . The first liver‐kidney transplantation at our institute was performed in 1996 for a pediatric patient suffering from PH1.…”

Section: Discussionmentioning

confidence: 99%

Longterm renal allograft survival after sequential liver‐kidney transplantation from a single living donor

et al. 2017

View full text Add to dashboard Cite

Combined liver-kidney transplantation (CLKT) is well established as a definitive therapy with the potential to provide complete recovery for certain liver-kidney diseases, although the results might be contingent on the cause of transplantation. The purposes of the present study were to review the longterm outcome of renal allografts in CLKT patients from single living donors and to investigate the beneficial factors, compared with solitary renal transplantation. Thirteen patients underwent sequential liver transplantation (LT) and kidney transplantation (KT) from single living donors. The indications for KT were oxaluria (n = 7), autosomal recessive polycystic disease (n = 3), and others (n = 3). The same immunosuppressive regimen used after LT was also used after KT. KT was performed between 1.7 and 47.0 months after the LT. The overall patient survival rate was 92.3% at 10 years. In 12 of the 13 surviving patients, the renal allografts were found to be functioning in 11 patients after a mean follow-up period of 103.6 months. The death-censored renal allograft survival rate at 10 years was 100%, which was better than that of KT alone (84.9%) in Japan. Immunological protection conferred by the preceding liver allograft may have contributed to the longterm outcomes of the renal allografts. In addition, the donation of double organs from a single living and related donor may have a favorable impact on the graft survival rate. In the future, investigations of factors affecting the longterm outcome of renal allografts, including details of the involvement of de novo donor-specific antibody, will be needed. Liver Transplantation 23 315-323 2017 AASLD.

show abstract

Section: Discussionmentioning

confidence: 99%

Longterm renal allograft survival after sequential liver‐kidney transplantation from a single living donor

et al. 2017

View full text Add to dashboard Cite

show abstract

“…The better the HLA match between liver and kidney, the lower the further incidence of acute rejection of the renal graft [ 8 , 14 ]. The protective effect of liver to kidney, coming from the same living-related donor and transplanted sequentially (SLKT; kidney after liver) to a pediatric recipient against positive cross-match and presence of donor-specific antibodies, has also been reported [ 15 ]. This effect of a good match on long-term outcomes has confirmed in a specific study, in which the same living-related donors were used for primary liver and then secondary kidney transplantation (SLKT; n = 13), with 100% (death-censored) 10-year graft survival [ 2 ].…”

Section: Immunoprotection and Immunosuppressionmentioning

confidence: 99%

“…The liver transplantation was complicated with rapid progression of chronic renal failure and 4 months later the kidney was transplanted. Both grafts were functioning at 1.5-year follow-up [ 15 ].…”

Section: Indicationsmentioning

confidence: 99%

Combined and sequential liver–kidney transplantation in children

Grenda

Kaliciński

2018

Pediatr Nephrol

View full text Add to dashboard Cite

Combined and sequential liver–kidney transplantation (CLKT and SLKT) is a definitive treatment in children with end-stage organ failure. There are two major indications: - terminal insufficiency of both organs, or - need for transplanting new liver as a source of lacking enzyme or specific regulator of the immune system in a patient with renal failure. A third (uncommon) option is secondary end-stage renal failure in liver transplant recipients. These three clinical settings use distinct qualification algorithms. The most common indications include primary hyperoxaluria type 1 (PH1) and autosomal recessive polycystic kidney disease (ARPKD), followed by liver diseases associated with occasional kidney failure. Availability of anti-C5a antibody (eculizumab) has limited the validity of CLKT in genetic atypical hemolytic uremic syndrome (aHUS). The liver coming from the same donor as renal graft (in CLKT) is immunologically protective for the kidney and this provides long-term rejection-free follow-up. No such protection is observed in SLKT, when both organs come from different donors, except uncommon cases of living donation of both organs. Overall long-term outcome in CLKT in terms of graft survival is good and not different from isolated liver or kidney transplantation, however patient survival is inferior due to complexity of this procedure.

show abstract

“…SLKT may be more feasible when liver and kidney grafts come from the same living donors . However, donor‐specific antibodies can be formed after LT and may need pretreatment, such as PE, before KT from the same living donor . When liver and kidney grafts come from deceased donors, CLKT may be a practical and acceptable approach, because one cannot know the timing of both of the transplant procedures if SLKT is to be performed .…”

Section: Discussionmentioning

confidence: 99%

Individualized concept for the treatment of autosomal recessive polycystic kidney disease with end‐stage renal disease

Miura

Sato

Yabuuchi

et al. 2020

Pediatric Transplantation

Self Cite

View full text Add to dashboard Cite

Management of children with autosomal recessive polycystic kidney disease (ARPKD) who develop end‐stage renal disease (ESRD) remains challenging because of concomitant liver disease. Patients with recurrent cholangitis are candidates for liver‐kidney transplantation, while the treatment for patients with splenomegaly and pancytopenia due to portal hypertension is controversial. Herein, we report 7 children who were treated using an individualized treatment strategy stratified by liver disease. Two patients with recurrent cholangitis underwent sequential liver‐kidney transplantation, while 4 patients with splenomegaly and pancytopenia but without recurrent cholangitis underwent splenectomy followed by isolated kidney transplantation. The remaining patient, who did not have cholangitis and pancytopenia, underwent isolated kidney transplantation. Blood cell counts were normalized after splenectomy was performed at the median age of 8.7 (range, 7.4‐11.7) years. Kidney transplantation was performed at the median age of 8.8 (range, 1.9‐14.7) years in all patients. Overwhelming post‐splenectomy infections and cholangitis did not occur during the median follow‐up period of 6.3 (range, 1.0‐13.2) years. The estimated glomerular filtration rate at the last follow‐up was 53 (range, 35‐107) mL/min/1.73 m2. No graft loss occurred. Our individualized treatment strategy stratified by recurrent cholangitis and pancytopenia can be a feasible strategy for children with ARPKD who develop ESRD and warrants further evaluation.

show abstract

Sequential liver–kidney transplantation in a boy with congenital hepatic fibrosis and nephronophthisis from a living donor

Cited by 11 publications

References 23 publications

Longterm renal allograft survival after sequential liver‐kidney transplantation from a single living donor

Longterm renal allograft survival after sequential liver‐kidney transplantation from a single living donor

Combined and sequential liver–kidney transplantation in children

Individualized concept for the treatment of autosomal recessive polycystic kidney disease with end‐stage renal disease

Contact Info

Product

Resources

About